Individual
MADRID USO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2700 WASHBURN WAY, KLAMATH FALLS, OR 97603-4518
(541) 884-5464
(541) 850-8847
Mailing address
2700 WASHBURN WAY, KLAMATH FALLS, OR 97603-4518
(541) 884-5464
(541) 850-8847
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D8626
OR
Other
Enumeration date
08/22/2006
Last updated
07/08/2007
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